Enechukwu Anieto Onochie Matthias, Stögner Viola-Antonia, Vogt Peter M
Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Chirurgie (Heidelb). 2022 Oct;93(10):1007-1018. doi: 10.1007/s00104-021-01566-8. Epub 2022 Jan 28.
Autologous tissue reconstruction for defect coverage of lower extremity wounds describes a broad interdisciplinary spectrum of conservative, surgical and interventional treatment options. The goals of reconstruction are a resilient and function-preserving but also esthetically acceptable wound closure, which should enable rehabilitation and the return to participation in social and working life for those affected. Depending on the wound conditions as well as on potentially occurring concomitant injuries and comorbidities, the timing and method of defect coverage is selected in an individualized approach for each patient. It is essential that the plastic surgeon is involved as early as possible in the preparation of a treatment plan and can then select the most appropriate and least invasive reconstructive procedure from the armamentarium, depending on the localization and etiology of the soft tissue defect. These vary from secondary wound closure to skin grafts up to local and free flaps.
自体组织重建用于下肢伤口缺损覆盖描述了一系列广泛的保守、手术和介入治疗选择,涉及多个学科。重建的目标是实现有弹性、保留功能且在美学上可接受的伤口闭合,这应能使受影响者康复并重新参与社会和工作生活。根据伤口情况以及可能出现的伴随损伤和合并症,针对每位患者以个体化方式选择缺损覆盖的时机和方法。整形外科医生尽早参与治疗计划的制定至关重要,然后可根据软组织缺损的部位和病因,从可用方法中选择最合适且侵入性最小的重建手术,这些方法从二期伤口闭合到皮肤移植,再到局部和游离皮瓣不等。